Lobo G, Ladrón de Guevara D, Salgado G, Donoso G, Bagus F
Unidad de Medicina Nuclear, Hospital San Juan de Dios, Santiago de Chile.
Rev Med Chil. 1999 Feb;127(2):181-8.
The yield of bone scintigraphy is specially good in some types of neoplasia such as mammary and prostate carcinoma, whose metastases cause a marked osteoblastic reaction in bone.
To assess the usefulness of bone scintigraphy in patients with prostate carcinoma.
A retrospective analysis of bone scintigrams performed to 79 patients with prostate carcinoma aged 56 to 83 years old, describing their relationship with prostate specific antigen and bone pain. The predictive value of bone scan, prostate specific antigen and clinical variables was analyzed using Kaplan Meier survival tables.
Scintigraphy disclosed bone metastases in 22 patients (28%). The most frequently involved zones were pelvis (86%), rib cage (67%) and spine (57%). The association with pain was low specially for limbs, rib cage and skull. The better efficacy of prostate specific antigen for the prediction of bone metastases was obtained with a cutoff value of 50 ng/ml (sensitivity 72%, specificity 86%). With a cutoff value of 10 ng/ml, the negative predictive value was 100%. The only significant predictor of a lower patient survival was the presence of bone metastases on bone scintigraphy.
In this series of patients, bone scintigraphy was an excellent diagnostic tool for bone metastases and had a survival prognostic value.
骨闪烁扫描术在某些类型的肿瘤（如乳腺癌和前列腺癌）中具有特别好的诊断效果，这些肿瘤的转移会在骨骼中引起明显的成骨反应。
评估骨闪烁扫描术在前列腺癌患者中的应用价值。
对79例年龄在56至83岁之间的前列腺癌患者的骨闪烁扫描图进行回顾性分析，描述其与前列腺特异性抗原和骨痛的关系。使用Kaplan-Meier生存表分析骨扫描、前列腺特异性抗原和临床变量的预测价值。
闪烁扫描术在22例患者（28%）中发现了骨转移。最常受累的部位是骨盆（86%）、胸廓（67%）和脊柱（57%）。与疼痛的相关性较低，尤其是四肢、胸廓和颅骨。前列腺特异性抗原预测骨转移的最佳效能在临界值为50 ng/ml时获得（敏感性72%，特异性86%）。临界值为10 ng/ml时，阴性预测值为100%。患者生存率较低的唯一显著预测因素是骨闪烁扫描图上存在骨转移。
在这组患者中，骨闪烁扫描术是诊断骨转移的优秀工具，并且具有生存预后价值。
